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Governmental Public Health Powers During the COVID-19 PandemicStay-at-home Orders, Business Closures, and Travel Restrictions

Educational Objective
To understand the governments powers used during a pandemic
1 Credit CME

The president and all 50 governors have declared health emergencies to counteract the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). While researchers race to develop vaccines, officials are implementing physical distancing, including orders to stay at home, restricting travel, and closing nonessential businesses (see eFigure in the Supplement). To limit cross-border spread, more than a dozen states have issued mandatory quarantines for interstate travelers. Some models suggest physical distancing would have to persist for 3 months to mitigate the peak effects on health systems and could be required on an intermittent basis for 12 to 18 months.1 What legal powers do governments have? What is the role of the courts? How can public health be balanced with personal and economic rights?

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Article Information

Corresponding Author: Lawrence O. Gostin, JD, O’Neill Institute for National and Global Health Law, Georgetown University Law Center, 600 New Jersey Ave NW, Washington, DC 20001 (gostin@georgetown.edu).

Published Online: April 2, 2020. doi:10.1001/jama.2020.5460

Conflict of Interest Disclosures: None reported.

References
1.
Ferguson  NM , Laydon  D , Nedjati-Gilani  G ,  et al; Imperial College COVID-19 Response Team. Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand. Published March 16, 2020. Accessed March 30, 2020. https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf
2.
Qualls  N , Levitt  A , Kanade  N ,  et al.  Community mitigation guidelines to prevent pandemic influenza—United States, 2017.   MMWR Recomm Rep. 2017;66(1):1-34.PubMedGoogle ScholarCrossref
3.
Slaughter-House Cases, 83 US 36 (1873).
4.
New York v New St Mark’s Baths, 497 NYS2d 979 (Sup Ct 1986).
5.
Binford v Sununi, Order of NH Super Ct. Docket No. 217-2020-CV-00152. March 25, 2020.
6.
Smith v Avino, 91 F3d 105 (11th Cir 1996).
7.
Kaiser Family Foundation. State data and policy actions to address coronavirus. Updated March 30, 2020. Accessed March 30, 2020. https://www.kff.org/health-costs/issue-brief/state-data-and-policy-actions-to-address-coronavirus/
8.
Walker  PGT , Whittaker  C , Watson  O ,  et al; Imperial College COVID-19 Response Team. The global impact of COVID-19 and strategies for mitigation and suppression. Published March 16, 2020. Accessed March 31, 2020. https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-Global-Impact-26-03-2020v2.pdf
9.
Menotti v Seattle, 409 F3d 1113 (9th Cir 2005).
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